Challenging cases in infection prevention and control: proceedings from SHEA Spring 2025.

Area of Science:

• Healthcare Epidemiology
• Infection Prevention and Control
• Clinical Decision-Making

Background:

• Healthcare epidemiologists and infection prevention professionals often encounter complex clinical situations lacking evidence-based guidance.
• Decisions made in these scenarios have significant impacts on patient safety, healthcare worker protection, hospital operations, and legal/financial risks.

Purpose of the Study:

• To present three challenging cases from the Society for Healthcare Epidemiology of America (SHEA) Spring 2025 Conference.
• To share practical lessons learned from real-world infection prevention dilemmas.
• To contribute to the literature on decision-making under uncertainty in hospital epidemiology.

Main Methods:

• Case study analysis of intraoperative contamination during hip arthroplasty.
• Examination of infection prevention risks during a temporary hospital HVAC shutdown.
• Application of Failure Mode and Effect Analysis (FMEA) for cadaveric tissue policy development.

Main Results:

• Case 1: Demonstrated the importance of antiseptic decontamination, interdisciplinary communication, and preparedness for intraoperative contamination.
• Case 2: Highlighted the utility of real-time ventilation assessment tools like CO2 monitoring during HVAC disruptions.
• Case 3: Showcased FMEA as a structured approach for developing infection control policies in guideline-absent areas.

Conclusions:

• Complex healthcare epidemiology decisions often require navigating uncertainty.
• Structured risk assessment, proactive planning, and cross-disciplinary collaboration are crucial for mitigating harm.
• Systematic approaches can support safe infection prevention decision-making even without definitive evidence.